Clinical Work

Description

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1878 edition. Excerpt: ... even tho whole of the organ have been successfully removed by surgical operation. It has, however, been recommended that in suspected rupture, an incision should be made in the splenic region to remove the ruptured organ; but can this operation (splenotomy) be safely had recourse to, or can the diagnosis be always so sure as to warrant such an operation? 9o. Of the Seats of Ruptures.--The most common seats have appeared to me, from careful observations of about forty cases, to be the hilus and splenic vein; in some cases the spleen was found lacerated and in others almost divided inte two. Ruptures-have also been met with on the convex surface. lOo. Of the quantity and state of thecxtravasated blood. The quantity has always been found excessive, and the state of the extravasated blood fluid and dark, mixed up with masses of dark coagula in the vicinity of the spleen and in the pelvic cavity. The state of the extravasated blood may be said to be mostly fluid with scarcely one fourth of tho whole quantity in a coagulated state. This fluid state of tho extravasated blood is common enough in serous cavities, provided that the extravasated blood is precluded from contact with atmospheric air. The fact that (he blood does not coagulate when the atmospheric air is excluded may be looked upon as favouring internal haemorrhage; and hence the large quantity of extravasated blood found at autopsies. But it must also bo remembered that the blood has been found quite fluid, although extravasated during life; and I cannot, therefore, lay too much stress upon this fact, since it has already been falsely argued in our Court of Assizes that extravasated fluid blood should always be looked upon as a post-mortem lesion. I had last year a case of stab-wound of the...show more